[Synchronous diverticulitis: a case report.]. / Diverticulitis sincrónica: informe de un caso.

Diverticular colonic disease is not as common in developing nations as in western and industrialized societies, accounting for approximately 130 000 hospitalizations per year in the United States, being diverticulitis the most frequent complication. Synchronous presentation of this complication is very rare, with only one case reported in literature. We present a patient who presented with diffuse abdominal pain. Colonoscopy was performed identifying a mass in the sigmoid colon and a perforation in the cecum. Patient underwent total abdominal colectomy with ileorectal anastomosis and protective loop ileostomy. Histopathologic examination revealed synchronous complicated diverticular disease of the sigmoid and cecum. In this report we disclose this type of atypical presentation of diverticular disease and establish that the approach taken is safe and feasible.

[Pelvic angiomyxoma. A case report from National Institute of Medical Sciences and Nutrition, Salvador Zubiran.]. / Angiomixoma pélvico. Informe de un caso en el Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

An angiomyxoma is a pelvic neoplasia compound of myofibroblasts. This is a case report of a 41 years old female patient, who presented with a painful, pelvic mass, identified by a tomography with malignant characteristics. Total surgical excision was performed and coursed with good evolution time.

[Hereditary non-polyposis colorectal cancer associated with hereditary gastric cancer. A case report.]. / Cáncer colorrectal hereditario no polipósico asociado a cáncer gástrico hereditario. Informe de un caso.

The information regarding the association of gastric cancer and type 2 Lynch syndrome is limited. Previous studies have reported that both entities may be present in the same individual in less than 5% of the cases. The most frequent form of hereditary colorectal cancer is the Lynch syndrome or Hereditary Non-polyposic Colorectal Cancer, which is associated with germ-line mutation mostly of two genes, MLH1 and MSH2, which account for almost 90 percent of all identified mutations. The hereditary diffuse gastric cancer syndrome is caused by a germ-line mutation in the E-cadherin (CDH1) gene; only about 50 families with this syndrome have been reported. We present a case report of a patient who was diagnosed with both syndromes.

[Factors associated with survival in liver resection for metastatic colorectal carcinoma]. / Factores asociados a superviviencia en la resecciónhepática por metástasis de cáncer de colon y recto. Experiencia en el Instituto de Ciencias Médicasy Nutrición "Salvador Zubirán".

BACKGROUND: The liver is the organ in which often metastasize primary tumors. Knowledge of the etiology and forms of presentation of metastatic disease is key to deciding on the different treatment options. OBJECTIVE: Describe the surgical management of liver metastases in colorectal cancer and factors that affect the survival of patients. PATIENTS AND METHODS: We reviewed 43 cases of patients with metastatic liver cancer of the colon or rectum, who underwent liver surgery, attended January 1990 to December 2007. We analyzed demographic variables and perioperative associated with the survival of patients. There was the course and type of postoperative complications as well as the direct causes of mortality. RESULTS: Were conducted mostly metastasectomies (n = 25), followed by right hepatectomy (n = 9),and left hepatectomy (n = 9). Surgical mortality was 4.6% (n = 2). The survival rate at 1, 3 and 5 year were 45% (18 patients), 42.5% (18 patients)and 12.5% (5 patients), respectively. The presence of a single metastatic lesion (p = 0.006), size of the lesion larger than 5 cm (p = 0.003), positive lymph nodes (p = 0.002), synchronous tumor (p = 0.04),presence of extra hepatic disease (p = 0.01), positive margin (p = 0.001) and blood loss >2000 mL were significantly associated with a lower survival rate. CONCLUSION: After hepatic resection for metastatic colorectal cancer the presence of more than one tumor, > of 5 cm, with presence of synchronous tumor, nodes and positive margins, extra hepatic disease, as well blood loss > 2000 mL are factors associated with a worse survival.

[Pancreatic-duodenectomy for invasive colon cancer in a patient with Lynch syndrome. Case report.]. / Pancreatoduodenectomía por cáncer de colon invasor en un paciente con síndrome de Lynch; informe de un caso.

Despite the screening efforts in the general population and particularly in families with hereditary colon cancer, locally advanced colon cancer remains a common clinical problem. In block resection is considered mainstay therapy in these patients. The aim of this report is to present a case of right-sided colon cancer with a medullar phenotype invading the duodenum treated through in block resection. A case of a 54-year-old male with a family history of colon and pancreatic cancer with lower gastrointestinal tract bleeding is presented. Colonoscopy and computed tomography scan showed a tumor in the colonic hepatic flexure invading the duodenum. The patient underwent an in block resection of the right colon, duodenum, pancreas and antrum. The histopathological study showed a T4N0M0 adenocarcinoma invading the duodenum, pancreas and antrum with negative margins. His postoperative evolution was complicated with a pancreatic fistula, which resolved with conservative measures. In conclusion, in block resection is the treatment of choice for locally advanced colon cancer with invasion to duodenum and pancreas and should be performed in high-volume centers familiar with this type of procedures. Key words: pancreaticoduodenectomy, colon cancer, Lynch syndrome, pancreas, surgery, Mexico.

[Laparoscopic colorectal surgery: third level center experience.]. / Cirugía colorrectal laparoscópica:experiencia en un centro de tercer nivel.

BACKGROUND: The role of laparoscopic surgery in the management of colorectal pathologies is steal unclear. Some new evidence has shown some advantages over open procedures. Because it is a technically demanding procedure, the progress is very low, and used among few colorectal surgeons. OBJECTIVE: To describe the experience of laparoscopic colorectal surgery in a third level referral center, in a fourth year period. We analyzed short and median outcomes, for benign and malignant diseases. MATERIAL AND METHODS: A retrospective review of all colorectal laparoscopic procedures was analyzed in a period between June 2003 and July 2007. Procedures for benign and malignant diseases were included. RESULTS: One hundred and seventy cases were included, 52 (30%) for malignant and 118 (70%)for benign diseases. The main indication for surgery was diverticular disease followed by colorectal cancer and the most common procedure was sigmoidectomy followed by right colectomy. Conversion rate was 8.8% (15 patients) and overall morbidity and mortality were 12%, and less than 1% respectively.Oncologic results were evaluated with a median follow up of 2 years, for a loco regional recurrence rate of 6%. Mean number of nodes retrieved in the pathologic specimen were 15.69 (+/- 3.53). All malignant cases had negative margins. CONCLUSIONS: Laparoscopic colorectal procedures are safe and feasible, in large volume centers showing equivalent results when comparing with open procedures evidenced in world literature,about results of oncologic cases, due to the short follow up period we can t conclude about oncologic outcomes.